Strain rate derived from color Doppler myocardial imaging for assessment of fetal cardiac function.

Objective: Color Doppler myocardial imaging (CDMI) is a new multigated method that allows direct analysis of myocardial motion. It is superior to pulsed-wave tissue Doppler in its ability to generate new and important indices of myocardial function such as strain, strain rate and tissue tracking. The purpose of this study was to assess the feasibility of CDMI in the fetal heart.

Prediction of preterm delivery using changes in serum relaxin in low risk pregnancies.

Objective: To examine serum relaxin as a predictor of spontaneous preterm delivery.

Study Design: A prospective study of 2846 women with singleton pregnancies, from which a matched case-control study (84 cases of spontaneous preterm delivery before 37 weeks gestation and 175 controls) and a cohort (84 preterm and 399 term deliveries) were extracted.

Results: In the women with a subsequent preterm delivery the relaxin level decreased by 0.

Preterm delivery predicted by soluble CD163 and CRP in women with symptoms of preterm delivery.

Objective: To evaluate whether soluble CD163 (sCD163) and C-reactive protein (CRP) can predict spontaneous preterm delivery in women with symptoms of preterm delivery.

Design: Prospective cohort study. Setting Labour ward at a tertiary university hospital.

Biomarkers for the prediction of preterm delivery.

This structured review discusses the current literature on selected biomarkers and their ability to predict preterm delivery (PTD). Among symptomatic women, the likelihood ratio (LR+) for the prediction of PTD was found to be greater than 10 using amniotic fluid (AF) interleukin-6 (IL-6), AF Ureaplasma urealyticum, as well as a multi-marker consisting of cervical IL-6, cervical IL-8, and cervical length (CL). The LR+ was found to be between 5 and 10 for serum C-reactive protein (CRP).

Biphasic effect of relaxin, inhibitable by a collagenase inhibitor, on the strength of human fetal membranes.

Background: Relaxin has been proposed as a hormone involved in the collagen remodeling of the utero-placental unit.

Materials And Methods: Human fetal membrane explants were incubated with H1 or H2 relaxin for 48 hours and stretched until rupture in a materials testing machine. Co-incubation with a synthetic collagenase inhibitor was performed in order to examine whether the effects of relaxin could be inhibited.

Matrix metalloproteinases and their inhibitors in the cervical mucus plug at term of pregnancy.

Objective: This study was undertaken to evaluate the presence of matrix metalloproteinases (MMPs) and their inhibitors in the cervical mucus plug obtained during active labor at term.

Study Design: Cervical mucus plugs from 17 healthy women in normal active labor were homogenized, extracted, and analyzed by 4 different assays.

Results: Gelatin zymography revealed large amounts of MMP-2 and MMP-9, and triple-helical collagen degradation demonstrated collagenase activity (MMP-8).

The influence of amphotericin B and neomycin on the effect of human relaxin-2 on foetal membranes and isolated myometrium.

In vitro studies have documented effects of relaxin on utero-placental tissues. Previously unpublished experiments indicate that neomycin and amphotericin B in vitro influences the effect of human relaxin-2 on the strength of human foetal membranes. The aim of the current study was to investigate the interaction between neomycin and amphotericin B and human relaxin-2 using human foetal membranes, human myometrium and rat myometrium.

Dynamics of Streptococcus agalactiae colonization in women during and after pregnancy and in their infants.

The population dynamics of Streptococcus agalactiae (group B streptococci [GBS]) colonization of the vagina and anorectal area was investigated in a cohort of 77 Danish women during and after their pregnancy by a new sensitive method. The mean carriage rate among individual observations was 36%, and the cumulative carriage rate over the entire observation period was 54%. Examination of more than 1500 GBS isolates by pulsed-field gel electrophoresis demonstrated that the GBS population was remarkably homogeneous and stable in each carrier.

ADAM12: a novel first-trimester maternal serum marker for Down syndrome.

Objectives: The concentration of bioavailable insulin-like growth factor (IGF) I and II is important to foetal growth. It is regulated by insulin-like growth factor binding proteins (IGFBP) 1 through 6. Proteolytic cleavage of IGFBP-3 takes place in human pregnancy serum; accordingly, IGFBP-3 serum levels decrease markedly during pregnancy.

Neutrophil elastase and secretory leukocyte protease inhibitor in prelabor rupture of membranes, parturition and intra-amniotic infection.

Objective: Neutrophil elastase (NE), a multifunctional serine protease stored in azurophilic granules of mature neutrophils, is capable of intracellular degradation of proteins during phagocytosis and extracellular degradation of connective tissue during an inflammatory process. Secretory leukocyte protease inhibitor (SLPI) is a natural NE inhibitor present in amniotic fluid, fetal membranes and cervical mucus. An imbalance between NE and SLPI has been implicated as a mechanism of abnormal tissue destruction in chronic inflammatory diseases.

S-relaxin as a predictor of preterm delivery in women with symptoms of preterm labour.

Objective: To evaluate whether serum relaxin (S-relaxin) can predict spontaneous delivery before 34 weeks of gestation in high risk pregnancies.

Design: A prospective cohort study.

Setting: Calculated sample size was reached over a two-year period, during which 9507 women gave birth.

Antimicrobial factors in the cervical mucus plug.

Objective: The cervical mucus plug is positioned between the microbe-rich vagina and the normally sterile uterine cavity, which suggests a host defense function, but few relevant data are available. We analyzed the composition and antimicrobial activity of cervical mucus plugs.

Study Design: Cervical mucus plugs were collected from healthy women at delivery.

Serum 17 beta-estradiol in newborn and neonatal hip instability.

This study evaluates the association between the level of 17 beta-estradiol in the umbilical cord blood and neonatal hip instability (NHI) in a population-based prospective case-control study comprising 2,185 consecutively newborns. beta-Estradiol levels were measured with a standard fluoroimmunoassay kit. Neonatal hip instability was determined by the anterior dynamic ultrasound method.

An in vitro study of antibacterial properties of the cervical mucus plug in pregnancy.

Objective: To evaluate whether cervical mucus plugs are antibacterial in vitro.

Study Design: Cervical mucus plugs from 56 healthy women in labor were studied by 2 different antimicrobial assays: (1) analysis of the inhibition by the cervical mucus plug of several gram-positive and gram-negative bacteria by overlaying the cervical mucus plug onto an agar plate with imbedded bacteria, and (2) determination of the antibacterial property of the cervical mucus plug material by radial diffusion assay with group B Streptococcus and Escherichia coli.

Results: In the agar overlay assay, there was complete inhibition of clinical isolates of Staphylococcus saprophyticus, E coli, and Pseudomonas aeruginosa and patient-variable partial-to-complete inhibition of Enterococcus faecium, Staphylococcus aureus, Streptococcus pyogenes, and Streptococcus agalactiae.

Proteoglycans and hyaluronan in human fetal membranes.

Objective: The aim of this study was to describe the distributions of major extracellular matrix components, such as proteoglycans, collagen and hyaluronan, in the fetal membranes at term.

Study Design: Fetal membranes were obtained from elective cesarean deliveries at term. Guanidinium extracts were analyzed for proteoglycans with alcian blue precipitation, sodium dodecyl sulfate- polyacrylamide gel electrophoresis, and Western blotting and for hyaluronan with a radioimmunoassay.

Association between raised serum relaxin levels during the eighteenth gestational week and very preterm delivery.

Objective: Our aim was to evaluate a possible association between serum relaxin levels in the 18th gestational week and preterm delivery.

Study Design: We conducted a nested case-control study that was based on serum samples obtained in the 18th week of gestation from 1545 unselected healthy primiparous women. Eleven case subjects were delivered very early (9 spontaneously, 2 by indicated cesarean delivery) and 42 moderately early (41 spontaneously, 1 by indicated cesarean delivery); 123 control subjects (121 having spontaneous labor, 2 undergoing indicated cesarean delivery) were randomly selected among the women with delivery at term.

Antibacterial properties of human amnion and chorion in vitro.

Objective: The purpose of the present study was to explore the direct effects of amnion and chorion on bacterial growth in vitro including the antibacterial spectrum. Chorioamniotic membranes were obtained under sterile conditions from 13 healthy women undergoing elective cesarean section at term. Likewise, chorioamniotic membranes were obtained from 10 healthy women with spontaneous vaginal delivery at term.

Chorioamniotic membranes constitute a competent barrier to group b streptococcus in vitro.

Objective: To study the penetration of group B streptococcus (GBS) through human chorioamniotic membranes in vitro.

Study Design: Chorioamniotic membranes from seventeen healthy women were mounted onto glass cylinders and placed in tissue culture trays constituting a two-compartment system with a maternal compartment internally and a fetal compartment externally. GBS from healthy pregnant women and from newborn babies with sepsis were added to the maternal compartment at densities from 10(7) to 10(9) colony forming units (cfu) per ml.